Treatment for Disc Hernia by PLDD or
Percutaneous Laser Disc Decompression
Percutaneous Laser Disc Decompression alias PLDD is a medical procedure that uses laser beams to treat pain caused by disc hernia in back and neck. Over the past century, the traditional invasive laminectomy and discectomy procedures have been performed, yet since then, technology has improved and minimally invasive approaches have evolved.
PLDD or Percutaneous Laser Disc Decompression is the first of its kind procedure developed in the early 80’s. Over time, PLDD was fine-tuned by introducing an optic fiber inserted in the disc by X-ray guidance. The laser reduces the small portion of the inside disc material called nucleus pulposus. Since then, thousands of PLDD procedures have been successfully performed worldwide.
PLDD procedure is an alternative for conventional back surgery (laminectomy). The procedure dramatically minimizes the incidence of scarring and other complications of laminectomy. It is established that PLDD reduces the pressure between the discs and the pain and the nerve compression pain diminishes and disappears.
Dr. Choy and PLDD
In 1984, Dr. Choy and his co-workers introduced laser energy into herniated/protruded disc to vaporize a small volume of nucleus pulposus, reducing the spine pressure, leading to migration of the herniated portion away from the involved nerve root. This model was tested successfully first in Columbia University, by the College of Physicians and Surgeons in New York City and in the neurological institute in Austria.
Dr. GIAN PAOLO TASSI got his Degree in Medicine and Surgery at the University of Chieti, Magna Cum Laudae in February 1990, and specialized in Neurosurgery at the University of Modena and Reggio Emilia. Later he did voluteer work and also worked as a neurosurgery consultant in several hospitals.
Since 1992, Dr. Gian Paolo Tassi has performed more than 1,800 neurosurgical procedures and more than 3,500 PLDD procedures having the largest world's PLDD experience after Dr. Johannes Hellinger from Munich (Germany) and Dr. Daniel S.J. Coy from New York City (the inventor of the PLDD and the tutor of Dr. Gian Paolo Tassi); both, Dr. Hellinger and Dr. Choy have retired 1 years ago due to their age. Dr. Gian Paolo Tassi has published also 40 scientific publications as an author and co-author in Neurosurgery.
He won first prize for the best Lecture at the PLDD 12th International Congress of IMLAS - Istanbul June 2005, and is a member of The New York Academy of Sciences after working with renowned Dr. Choy. Dr. Gian Paolo Tassi is also:
- Member of the Italian Society of Neurosurgery
- Member of the European Skull Base Society
- Member of the International Society Laser Muscleskeletal
The main thing that differentiates Dr. Gian Paolo Tassi from other spine care specialists in Italy is that he has been using Dr. Choy’s PLDD treatment method for Percutaneous Laser Disc Hernia, being the only doctor in Italy currently authorized to use this method, being trained by Dr. Choy himself.
Dr. Choy's PLDD treatment method is available in 2 clinics in Italy where Dr. Gian Paolo Tassi works, such as Rome, but mainly San Benedetto del Tronto in Marche region, in Italy.
Percutaneous Laser Disc Decompression PLDD
Percutaneous Laser Disc Decompression Therapy for Disk Hernias, Cervical, Dorsal (except for the T1-T5) and Lumbar (not to be confused with other Laser Treatments) is a new technique for NON-SURGICAL procedure made under local anesthesia, in Italy. The nucleus pulpous of the inter vertebral space concerned is struck by a laser beam after the introduction of an optical fiber; this one is placed in contact with the nucleus pulpous through a needle placed in the patient's back: all under X-Ray control. From the physical point of view PLDD produces a vaporization of at least part of the nucleus pulpous and determines the affected nerve decompression (the aim of the procedure is not the reduction or disappearance of the hernia but the marked reduction of pressure on the nerve).
Percutaneous Laser Disc Decompression was invented in the United States in the 80's by Prof. Daniel Choy. Dr. Tassi had the honor and good fortune to practice at Columbia University in Manhattan (New York). Dr.Tassi said "thanks to the one who created PLDD that works". Since the beginning of clinical trials to date about 4,000 patients were treated by Prof. Choy.
After treatment, which has a variable duration from 30 to 60 minutes, the patient is recommended to rest in bed for 24 hours and the next day he may begin a gradual recovery. The patient can resume their work within 15 to 30 days (depending on the type of work carried out). In 3% of cases the disk hernia cannot be reached but this is only verifiable during the procedure.
Thanks to technical specification, there is no need for skin lesions and there is no muscle damage. The removal of ligaments and bone is not necessary. In conclusion, all the procedures used in the classic surgical approach (orthopedic or microneurochirurgico) that usually involve complications uch as adherence for perpendicular lesions, spinal instability, pain from muscle damage etc. are now history because of PLDD. However, in those patients in whom the PLDD treatment did not produce the success hoped, the surgical procedure is not PRECLUDED by ANY MEANS.
Percutaneous Laser Disc Decompression best works for:
- Patients with single/multiple disc protrusion or patients with real disk hernias documented examination of magnetic resonance imaging (MRI) or Computerized Axial Tomography (TAC) (these exams must not be more than 90/120 days old.
- Patients who have not responded to the classical conservative therapies (rest, anti-inflammatory medications and muscle relaxants, psychiatric therapies);
- Patients with relapses from post-surgical hernia repair.
Who cannot benefit from this technique?
- Patients with severe spinal arthroscopy processes or calcified hernias;
- Patients with completely expelled hernia and/or disk fragments migrated;
- Patients with vacuum disk (i.e. with small air bubbles at the level of the inter-vertebral disk)
- Patients with severe lumbar spinal canal stenosis.
- Hemorrhagic Diathesis
- Spondilolistesis medium or serious degree
Results and post-treatment recommendations:
- 85% of patients symptoms and/or lombosciatalgica lombalgica dissapear. In 70% of cases it happens in the first 2-3 weeks, in the remaining 30% it takes from 3 to 10 weeks. In 4% of cases, in the first 5 years after treatment, relapses may occur (quite often in such cases, you can repeat the treatment)
- In about 10% of cases for the first 4-5 days there is a presence of more or less distinct lumbar pain (entry point laser fiber) which can be eased with the use of local application of ice.
- Patients are discharged after 72 hours at most hospitals;
- Is recommended bed rest for the first 24 hours;
- Gradual gait (10-15 minutes for 3-4 times per day) is recommended for the next 3 days;
- The patient may resume their work in a range of 15 to 30 days (depending on the type of work performed
- Clinical audits must be carried out in 2, to 6 months and one year
- In cervical hernias is recommended the use of cervical collar of Shantz for 4-5 days while in lumbar hernias is recommended using a lumbar corset fence for 15-30 days
Dr. Tassi's PLDD Method in the Media
Herniated Disk Laser Care
Arrives in Italy the "percutaneous laser disc decompression", a quick and painless method to heal disk hernia, for now (2003) made in Florence on 40 volunteer patients. Unlike traditional surgery, complex and invasive, laser technique achieves the target with pinpoint accuracy by a thin needle, without causing damage to the surrounding tissues, the intervention lasts 10 minutes, under local anesthesia, and does not require sutures and scars.
Neurosurgery Awards to dr. Tassi for laser surgery
Neurosurgery Awards to dr. Tassi for interventions with the Important recognition for laser Dr Gian Paolo Tassi. The young neurosurgeon from San Benedetteo neurosurgery unit at the hospital Mazzini di Teramo, starred with prof. Daniel S.J. Choy at the 17th International Congress on lasers in Medicine in Florence, where, for the first time in Italy, two percutaneous laser disc decompression surgeries were carried out to treat intervertebral disc herniation".
The innovative procedure has allowed the two doctors to intervene in local anesthesia and without need of surgical incisions. This ensures patients, as well as the opportunity to be discharged in a few hours or at most the next day to attend, including full and immediate functionality and mobility of the trunk and limbs. The outcome of the procedure, carried out on patients of Dr. Tassi was extremely positive. Both patients have returned home the next day. The collaboration between prof. Choy and Dr. Tassi has thus allowed the access in Italy to this revolutionary procedure and these first positive interventions open new and best scenarios in vertebral disc pathology care.
06 Novembre 2002
The new technique for disc hernia
A new technique, born in USA, could be used in Italy for disc hernia: percutaneous laser disc decompression.
- It is a technique that, compared to risky and complex traditional surgery, is unobtrusive and less risky for the delicate nerve structures around the hernia.
- Between the vertebrae there are discs that acts as a link. Each disc is made for the 75 percent by water and is surrounded by a capsule.
- An injury or wear and tear can weaken the capsule; as a result of pressure from the vertebrae, part of the contents of the disc is pushed outwards, forming a hernia, which in turn presses on the nerves of the back and legs, causing excruciating pain.
The laser technique, unlike the traditional one which is based on removing the disc, PLDD aims to relieve pain while saving the disk.
- In practice, under local anesthesia is stuck a needle-cannula in the back which is applied an optical fiber.
- Optical fiber is placed until the affected disk; laser pulses are directed to the area, vaporizing the water in the disk volume, to avoid the nerve compression.
Neurosurgeon Opera of St. Benedict with Ernie Laser Disc
St. Benedict-From now on, the Olympus of medicine and science applied to health, San Benedetto can boast of having Dr. Gian Paolo Tassi. The young and good neurosurgeon neurosurgery Unit of the Hospital 'Mazzini' of Teramo, was the star, with Professor Daniel Choy, of Columbia University, at the 17th International Congress on Laser in Medicine, where, for the first time ever in Italy, have been planned interventions 'percutaneous laser decompression of herniated intervertebral disc'. The innovative procedure has allowed the doctor Rates and Professor Choy to intervene in local anesthesia and without the need for surgical incisions. Granted the benefit to patients: the ability to be discharged a few hours after surgery with the laser (at most the next day) and also the full functionality and mobility of the trunk and limbs. To be specific, the results of operations of Dr. rates of patients (one in the province of Teramo and the top of the Province of Ascoli), has been extremely positive. Both have returned to cash the next day. The collaboration between Dr. rates and prof. Choy has thus allowed to enter Italy's revolutionary procedure that opens up new scenarios in the treatment of painful and disabling disease of the spinal discs.
Il Resto del Carlino
November 5, 2002
New applications for the laser beam from the footsteps of the dinosaurs ... herniated disc
From dinosaurs ... herniated disc. They are two different (and new) scientific fields in which the laser is used, the powerful beam of light, from the discovery to the present, never ceases to amaze us with its versatility. And here is the news about the Jurassic beasts: the hundreds of traces of dinosaur unearthed recently in Courtedoux in Switzerland and dating back to 150 million years ago, will be studied with a special high-resolution laser scanner that will allow palentologi to create a model three-dimensional fingerprints and to understand more on the evolution of giant animals. In the spirit of the laser beam, is the cure, it seems conclusive, herniated disc, a painful and debilitating disease growing in the world. The technique developed by Professor Daniel Choy, a neurosurgeon at Columbia University in New York, who will be demonstrating in Florence in the coming days, allows direct intervention sull'ernia, with precision, without damaging - as is the case with traditional surgical methods - the delicate surrounding tissues.
October 30, 2002
Herniated disc surgery with the laser in 10 minutes
Professor Choy is the inventor of a new minimally invasive technique to operate a herniated disc, the painful and disabling disease of the spinal discs. The discs, recalls Choy, are composed of a substance incompressible, formed for 75% water, enclosed in a capsule ligament. When the capsule is weakened, for a trauma or other wear processes, a part of the content is pushed outwards by the pressure exerted by the vertebrae. Here is the hernia that can compress various nerves that branch out from the column, causing pain and disability. Unlike traditional surgery more risky and complex because invasive than the delicate nerve structures surrounding the hernia, laser surgery, according to the professor, is able to reach the target with the pinpoint accuracy of a thin needle, causing damage to delicate fabrics circostanti.L 'operation takes only 10 minutes, there is only a mild local anesthesia, can be performed in the clinic, the patient feels no pain and can move immediately after the operation. You just need to avoid heavy exercise within 5 days and there are no sutures or scars. [Hansa]
October 31, 2002
Laser disc herniation by Dr. Gian Paolo Tassi
The PLDD (Percutaneous Laser Disc Decompression) was invented by Prof. Daniel SJ Choy (Director of Laser Spine Center of Columbia University in New York) who applied it for the first time on a patient in February 1986 in Graz (Austria) in collaboration with Prof. PW Ascher. In 1991 the FDA approved and certified the PLDD. Since 1986 Prof. D. Choy has treated about 3000 patients with PLDD (for hernias located at all levels of the spine: cervical, dorsal and lumbar). In October 2002, for the first time in Italy, Prof. D. Choy in collaboration with Dr. Gian Paolo Tassi performed 2 procedures PLDD of Italian patients of Dr. rates. The PLDD is a truly minimally invasive procedure that can be applied on a large group of patients with low back pain and / or sciatica due to the presence of protrusions or herniated discs rebels to standard treatments pharmacological and physical. The technique, which can be conducted in an outpatient surgery, involves inserting a needle of small diameter within the nucleus pulposus of the intervertebral disc "sick" once you reach the target - under continuous fluoroscopic control - fits inside the needle guide a thin optical fiber laser in order to achieve it with the same nucleus pulposus. The whole is conducted with a mild local anesthetic. It 'important to respect some landmarks in order to avoid injury to major vascular or visceral organs. Equally important is the power of DECISIVE single laser pulse released, the global power at the end of the procedure, the pauses between the individual input, the laser source used. The goal of treatment does not consist in the removal of anatomical hernia or disc protrusion but in marked reduction of pressure on the structures of the same root neighboring using the vaporization of a small amount of nucleus pulposus. There are no real contraindications to PLDD except for patients who have a hemorrhagic diathesis or spondylolisthesis grade average or severe. There is possibility of treating more than a "hard" in a single session as well as can be treated even patients with hernia recurrence after surgery (and there are many!).
Dr. Gian Paolo Tassi since December 2002 has treated 228 herniated discs in 196 patients (16 patients were treated two spaces in a single session) with the second PLDD Choy Choy and 131 with method but with different laser source (980 nm diode .). The rusltati the study, analyzed the scal MacNab, showed positive results in 82, 6% of cases, unsatisfactory results were 17.4% (in this regard it is important to consider that these patients did not, however, experienced a worsening of the clinical symptoms and because of the treatment), and, to them it is not, however, precluded the need for surgery. In one case there was a "suspect" in discitis ("suspected" as it were performed serology and bacteriology because the patient improved after 10 days of antibiotic therapy and absolute rest in bed). Ultimately the PLDD is likely, and in my judgment (as neurosurgeon) certainly is the approach of choice for the truly minimally invasive treatment of wide spectrum of patients with symptomatic herniated discs and rebellious to the most common conservative treatment. The PLDD offers many advantages over traditional surgical procedures (orthopedic or microneurochirurgiche): less invasive, can be performed as day surgery, excellent results in the treatment of disc protrusion where the indication for surgery should never be placed; less time convalescence (with significant positive implications in the economic and social), no complications in experienced hands; conservation "substantial" structures of the spine, lack of fibrotic adhesions periradicular; absence of pain - even chronic - due to muscle damage post- surgical, non-use of general anesthesia and possibility of treating patients "heart failure" for other diseases or seniority.
The desire to start Roberto Beni.
This Boy's Life. It has to sell Roberto Goods after some difficult months in terms of football and beyond: December divorce from Grottammare which was the technician, then a nagging herniated disc that forced him to bed for some time.
"Finally I managed to solve the problem I had in the back, - says Beni - move me trouble for more than two months. I take this opportunity to thank Dr. Gianpaolo rates, neurosurgeon Order of St. Benedict, with a new technique imported from America (with laser disc decompression, ed) healed me by avoiding surgery. now I'm fine and I'm ready to go to market. "
By the way, there is nothing new about your future?
"For now there is nothing concrete. Unfortunately, football is this: last year, these days, I was celebrating reaching a milestone and unexpected (the conquest of D series at the helm of Grottammare, ed) and now instead? However, I had not gone to his head last year and I do not get depressed now that I'm out of action. far, I have not received interesting proposals, so I prefer to wait projects more serious. "
Indeed, an interesting proposal 's have received so much so that' you have readily accepted. I refer to the so-called 'Team Summer'.
"It's true. From 26 July to 13 August, will be the vice-Guerrini in the withdrawal of Cascia where he will train Estate Team, a group of football players, professional and amateur, in search of contract. I eagerly accepted the proposal of De Feis and Falsetti: I have, in fact, the opportunity to work for twenty days next to a coach like Guerrini that has more than two hundred benches between A and B. It will be a refresher course on field. "
And maybe, after this experience, comes a call.
"We hope so. loading and I'm really eager to return to the bench. During these six months I was apparently away from football: I took the opportunity, in fact, to turn Italy and to view different coaches and their methods of work. Moreover, the negative experience of last year has given me the right boost to get back in the game more convinced than before. "
Inevitably speak of Groton. To restart from your own weblog 2004-2005 old friend, Paolo Del Moro.
"Del Moro is one of the biggest purchases that Grottammare could do in addition to being a great player is also a man-locker key. Grottammare If we have reached certain results is also, and above all about Paul. "
And if after that of Del Moro, there was also the return of Goods?
"As for me, I just say that I left my heart in Grottammare and are still very close to Pignotti and Aniello. Whatever you do, do them a big good luck for next season. "
After the exemption in Grottammare have not done any kind of controversy. Months later you have something to say?
"prefer to speak with you journalists only positive things in my three years at Groton. Species last season, things not so good and there have been several disappointments but, as I said in December, I intend to keep them for me because I am convinced that I will need to grow in 'business coach. "
Roberto Beni, as in his style, dribbling the controversy and look ahead. Pending a bench.
Revolutionary method for herniated disc
Wednesday, October 20, beginning at 9 am at the Auditorium of the Public Library is scheduled for the first day of the meeting of the 1st Italian Meeting on PLDD (Percutaneous Laser Disc Decompression).
The PLDD is a minimally invasive surgical procedure useful in the treatment of certain categories of herniated intervertebral disc. It was invented and introduced in clinical use in 1986 by Prof. Daniel SJ Choy, of Columbia University in New York, who will participate in the Meeting.
At the end of the scientific reports (also worth mentioning the participation of Dr. Ovidio Marangoni Foundation "Glauco Netherlands "in Trieste, which is one of the most prominent Italian experts in laser applications in medicine and surgery), prof. Choy , in collaboration with Dr. Gian Paolo Tassi , will perform two live demonstrations (a "live surgery", as they say) for the treatment of cervical and lumbar erniediscali that will be provided by the operating rooms of the nursing home Villa Anna of San Benedetto del Tronto.
In particular, as regards the treatment of cervical disc herniations through PLDD, this is the first time that such a procedure is performed in Italy (only two centers in Europe using the same method, one led by prof. Martin Knight in Manchester and that of dr. Johannes Hellinger in Monaco).
The scientific event was made possible thanks to the sensitivity and availability of the Mayor of San Benedetto del Tronto, dr. Domenico Martinelli, dr. Umberto Boccabianca, dr. Francesco Salvi, dr. Piero Ripani dr. Vincent Gargano (respectively President, General Manager, Medical Director and Head of Surgery of the nursing home "Villa Anna") and dr. Luigi Pierangeli, president of the Nursing Home "Pierangeli" in Pescara at the Meeting which will end on the next day, October 21.
October 25, 2004
Surgery, new frontiers
S. BENEDICT - Dr. Gianfranco Salvi, director of the nursing home Villa Anna << >>, praised the initiative of Dr. Gian Paolo Tassi, supported by Professor Daniel SJ Choy, of Columbia University in New York: << We are seeing live video Municipal Auditorium, the first operation in Italy with the system PLDD (Percutaneous Laser Disc Decompression), the prof. And Dr. Choy. Rates are performing at the nursing home "Villa Anna", located a few hundred meters >>. The revolutionary surgical procedure for the treatment of certain categories of herniated disc, has been applied to a patient suffering from excruciating pain for a herniated cervical disc.
<< interventions made so far - says Dr. rates - were only to remove protrusions and herniated lumbar >>. With the system PLDD, rates materialize the teaching of prof. Choy, continuing with the removal of cervical disc herniations. Many benefits: local anesthesia, hospitalization for 48 hours and return to work quickly.
Il Resto del Carlino
October 19, 2004
Minimally invasive surgery for herniated disc
SAINT BENEDICT - The name is roborante: "Percutaneous Laser Disc Decompression." Practically, is the revolutionary minimally invasive surgical procedure, for the treatment of certain categories of disc herniations. Who invented it in 1986, Professor Daniel SJ Choy, Columbia University, New York, will be in San Benedetto day of work tomorrow at the 1st Meeting of the Italian PLDD which will begin at 9 am at the Auditorium in Viale De Gasperi. The meeting - comparison doctor is undoubtedly important, because at the end of the scientific reports (including Dr. Ovidio Marangoni Foundation "Glauco Bass" in Trieste, one of the most prominent Italian experts in laser applications in medicine and surgery), Prof. Choy , in collaboration with Dr. Gian Paolo Tassi, will perform live on television (from the operating theaters of the nursing home "Villa Anna"), some demonstrations for the treatment of herniated discs, cervical and lumbar vertebrae, with the system PLDD. << Procedure - Anticipate Dr. rates - that is performed for the first time in Italy >>. 's scientific event was made possible thanks to the sensitivity of the Mayor Martinelli, the top administrative and medical care of the house "Villa Anna" and Dr. Luigi Piangerelli.
October 19, 2004
Italy: “Dolce far niente…”
The name of the region comes from the Middle Ages and it is related to the nearby marches of Camerino and Fermo, but mostly to the medieval March of Ancona.
It is a mountain region with an infrastructure that will allow you to travel between the great cities, yet when looking for the Italian rural experience you may find yourself on a narrow path (literally). The landscape is one that gives peace to the eye of the beholder and when entering the cities and towns calm will surround you. The main cities in Marche are located on the coast of the Adriatic, such as San Benedetto del Tronto, Ancona and Civitanova Marche.
The food culture of Marche is quite exotic one might think. The main reason for this is because of the influences from other regions and invaders throughout its long history.
On the coast you will find dishes of fish and seafood while in the hills, chicken and pork. There are many type of pork sausages made in Marche, among the favorites there is a local smoked sausage - ciauscolo, made of half pork and half pork fat. Among the spices used for these you may be surprised to find orange peel and fennel seed.
In cheeses, Marche has its own cheese called Casciotta d'Urbino, made from sheep and cow milk. Ambra di Talamello is also made here from goat, sheep or cow milk and the pit lined with straw where the cheese rests gives it an appreciated earthy flavor. You can also try the pecorino cheeses, which can be found in Marche as well.
The traditional pasta here is a “must see and try”. Rich with eggs, the pasta consists of wide noodles like lasagna and papparadelle in the forefront. The region's signature dish vincisgrassi also includes pasta as a main ingredient along with meat sauce. You may also be served “spaghetti alla chitarra”, “tagliatelle” and “maccheroncini”.
Although it is a difficult area to get to, the Marche rural region is well worth the effort, as it remains, in the 21st century, one of Italy's best-kept culinary secrets.
San Benedetto del Tronto
San Benedetto del Tronto, also called the Palm trees Riviera, is a popular destination on the Adriatic coast. Lying gracefully on the coast of the Adriatic Sea, it is an active fishing port and one of the main seaside resorts on the central Adriatic coast and the Mediterranean. The cultural offer in Marche is quite extensive, with many museums and historical landmarks dating from the Middle Ages, along with the wines and local cuisine, you are sure to have a proper Mediterranean experience.
When visiting this beautiful Italian city, you can reach quickly both the enchanting landscape of hills and the highest peaks of the central Apennines.
Besides the great nightlife, which you can profit from all year round, in February, the city hosts a carnival parade and in March, the final stage finish of the Tirreno–Adriatico bicycle race fills the main streets of San Benedetto del Tronto.